Accident Disability Insurance Benefit
SLPC 25439 7/16 (exp. 7/18)
Sun Life's accident insurance plans – Essential and Preferred – include an optional Accident Disability Insurance Benefit. Injured employees and spouses can count on a weekly stream of income if they become Totally Disabled as a result of a covered accident. Disability for spouses is defined as the inability to perform two or more Activities of Daily Living.
How does it work?
Employees and their spouses choose a flat dollar weekly benefit amount of coverage. If a serious injury occurs, we start paying the insured person once the Elimination Period is satisfied.
The benefit is available for any covered accident, such as a fall, sports injury, or traffic accident, that results in the insured becoming Totally Disabled. The benefit is paid regardless of any other disability insurance the employee or spouse may have.
Key benefits for...
* The Disability Insurance Benefit is not available for spouses in New York.
If permitted by the Employer's employee benefit plan and not prohibited by state law, the term "spouse" in this benefit includes any individual who is either recognized as a spouse, a registered domestic partner, or a partner in a civil union, or otherwise accorded the same rights as a spouse.
Accident Insurance is a limited benefit policy. It provides accident coverage only and does not provide basic hospital, basic medical, or major medical insurance. This coverage does not constitute comprehensive health insurance (often referred to as "major medical coverage") and does not satisfy the requirement for Minimum Essential Coverage under the Affordable Care Act. Failing to maintain Minimum Essential Coverage may result in a tax penalty.
The certificate and its riders have exclusions and limitations that may affect any benefits payable. Benefits payable are subject to all terms and conditions of the certificate. The policy, certificate, and any rider, if applicable, may not be available in all states.
For policies issued in New York: The expected benefit ratio for this policy is 65%. This ratio is the portion of future premiums which the Company expects to return as benefits, when averaged over all people with the policy.
Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 93P-LH, 98P-ADD, 07-SL REV 7-12, 07P-LH-PT/07C-LH-PT, 01P-ADD-PT/01C-ADD-PT, GP-A, GC-A, 12-GP-01, 12-DI-C-01, 13-SD-C-01, 12-AC-C-01,13-ADD-C-01, 12-GPPort-P-01, 13-ADDPort-C-01, 12-STDPort-C-01, 12-ACPort-C-01, 13-SDPort-C-01, TDBPOLICY-2006, and TDI-POLICY. In New York, group insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) under Policy Form Series 13-GP-LF-01, 13-LF-C-01, 13-GP-LH-01, 13-ADD-C-01, 13-LTD-C-01, 13-STD-C-01, 06P-NY-DBL, 07-NYSL REV 7-12, GP-A, GC-A, 12-GP-SD-01, 13-SD-C-01, 12-GP-01, 12-AC-C-01, 12-GPPort-01, 13-LFPort-C-01, 13-ADDPort-C-01, 12-STDPort-C-01, 12-ACPort-C-01 and 13-SDPort-C-01. Product offerings may not be available in all states and may vary depending on state laws and regulations.
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